Psychosis: Between Dreams and Perceptual Reality


  • Mirona Letiția Dobri “Socola” Institute of Psychiatry Iași
  • Alina-Ioana Voinea Hertfordshire Partnership University NHS Foundation Trust, St. Albans
  • Codrina Moraru “Socola” Institute of Psychiatry Iași
  • Petronela Nechita “Socola” Institute of Psychiatry Iași
  • Anamaria Ciubara “Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galați



psychosis, dreaming, REM sleep, lucid dreaming


From the beginning of time, the layman always described and understood psychosis as a dream-like state. Researchers have characterized both psychosis and dreaming with common denominators, both displaying visuomotor hallucinations, loose associations, metacognitive deficit, impaired reality discrimination, strong emotional component, resulting in a general lack of insight. The association of psychosis with dreaming was present in literature centuries ago, in the works of great thinkers such as Kant and Schopenhauer, which prompted many modern specialists to delve deeper into studying this connection for a better understanding of psychosis and possible applications in the clinical practice. During REM sleep, which is the most associated with dreaming, visual and motor areas in the brain show increased activation, which is congruent with the presence of hallucinations, the hallmark of the dreaming state. Also, the amygdala, involved in emotion regulation, has a prominent role in the sleeping brain. The deactivation of parts of the prefrontal cortex translate in altered capacity for making decisions and critical thinking. Several neuroimaging studies have shown similar neural patterns in the wakeful state of psychotic patients, especially those associated with the presence or absence of insight. As insight is thought to play a major role in treatment compliance and quality of life in psychotic patients, it is the most studied element linking psychosis and REM sleep. Lucid dreaming is a state of awareness of dreaming, while the individual is still asleep. The dreamer has a degree of control of the narrative and capacity for self-reflection, aspects deemed as insight. Lucid dreaming is a rare occurrence, but has the potential to be trained, concept with great relevance in researching modalities for insight gain in psychotic patients. In conclusion, the research of insight present in lucid dreaming shows great prospect for developing better interventions that target the lack of it in psychotic patients, thus contributing to significant improvement in their prognosis, quality of life and treatment compliance.


Baird, B., Mota-Rolim, S., & Dresler, M. (2019). The cognitive neuroscience of lucid dreaming. Neuroscience and Biobehavioral Reviews, 100, 305–323.

Chirita, R., Sacuiu, I., Burlea, A., & Chirita, V. (2012). The role of nitric oxide inhibitors in treatment on symptom severity and cognitive deficits in schizophrenia. International Journal Of Neuropsychopharmacology, 15, 113-113.

Dresler, M., Wehrle, R., Spoormaker, V. I., Steiger, A., Holsboer, F., Czisch, M., & Hobson, J. A. (2014). Neural correlates of insight in dreaming and psychosis. Sleep Medicine Reviews, 20, 92-99.

Eiser A. (2005). Physiology and Psychology of Dreams. Seminars in Neurology, 25(1), 97-105

Limosani, I., D’Agostino, A., Manzonea, L. M., & Scarone, S. (2011). The dreaming brain/mind, consciousness and psychosis. Consciousness and Cognition, 20, 987–992.

Macêdo, T. C. F., Ferreira, G. H., Almondes, K. M., Kirov, R., & Mota-Rolim, S. A. (2019). My Dream, My Rules: Can Lucid Dreaming Treat Nightmares? Frontiers in Psychology, 10, 2618.

Mota, N. B., Resende, A., Mota-Rolim, S. A., Copelli, M., & Ribeiro, S. (2016). Psychosis and the Control of Lucid Dreaming. Frontiers in Psychology, 7, 294.

Mota-Rolim, S. A., & Araujo, J. F. (2013). Neurobiology and clinical implications of lucid dreaming. Medical Hypotheses, 81(5), 751-756.

Vallat, R., & Ruby, P. M. (2019). Is It a Good Idea to Cultivate Lucid Dreaming? Frontiers in Psychology, 10, 2585.

Voss, U., D’agostino, A., Kolibius, L., Klimke, A., Scarone, S., & Hobson, A. (2018). Insight and dissociation in lucid dreaming and psychosis. Frontiers in Psychology, 9, 2164.

Voss, U., Holzmann, R., Tuin, I., & Hobson, A. (2009). Lucid dreaming: a state of consciousness with features of both waking and non-lucid dreaming. Sleep, 32(9), 1191-1200.




How to Cite

Dobri, M. L., Voinea, A.-I., Moraru, C., Nechita, P., & Ciubara, A. (2020). Psychosis: Between Dreams and Perceptual Reality . BRAIN. Broad Research in Artificial Intelligence and Neuroscience, 11(3Sup1), 146-152.

Most read articles by the same author(s)

1 2 3 4 5 > >> 

Publish your work at the Scientific Publishing House LUMEN

It easy with us: publish now your work, novel, research, proceeding at Lumen Scientific Publishing House

Send your manuscript right now